Reference:
Supplies
- Small Gelpi retractors - 2x -holding lateral and dorsoventral aspects of incision open after circumferential dissection
- Electrocautery
- Allis forceps holding onto the urethral catheter
- Lap pads
- A small red rubber catheter
- Iris scissors
Procedure
- Place the urethral catheter
- Sternal recumbency
- Circumferential incision
- The incision should be larger than you think to give plenty of space to suture the urethra.
- Isolate penis
- Cut muscles on lateral aspect penis electrocautery - ischiocavernosus muscle; pass finger on each side.
- Dissect the retractor penis muscle from the dorsal aspect of the penis, transect it proximally and remove it to expose the urethra on the dorsal surface of the penis.
- Be careful with dorsal dissection!
- Clean the dorsal surface of the penis with Metzenbaum scissors
- Be careful with dorsal dissection!!
- Cut ligament ventral w/ scissors; pass finger
- Next, carefully incise the urethra at a distal location with a scalpel blade to make a small stab incision over the urinary catheter. Incise into the dorsal aspect of the urethra with iris scissors.
- Suture urethra to skin after confirming the proper level of tension
- Amputate the distal to lower midsection of the urethra /penis as this will necrose otherwise
- Suture mucosa of the urethra to skin after confirming the proper level of tension
- Insert a small red rubber catheter before suturing the mucosal urethra
- You should be able to insert mosquito forceps up to the box of the forceps